A Systematic Review of Fear of Cancer Recurrence Among Indigenous and Minority Peoples
Open accessAbstract
While cancer survivors commonly experience fear and anxiety, a substantial minority experience an enduring and debilitating fear that their cancer will return; a condition commonly referred to as fear of cancer recurrence (FCR). Despite recent advances in this area, little is known about FCR among people from Indigenous or other ethnic and racial minority populations. Given the high prevalence and poor outcomes of cancer among people from these populations, a robust understanding of FCR among people from these groups is critical. The current review identified and aggregated existing literature on FCR amongst adult cancer survivors from Indigenous and minority populations. The protocol of this review was registered with PROSPERO in July 2020 (Registration number: CRD42020161655). A systematic search of bibliographic databases was conducted for relevant articles published from 1997 to November 2019. Data from eligible articles were extracted and appraised for quality by two independent reviewers. Nineteen articles from four countries (United States of America, Canada, Australia and the United Kingdom) met the inclusion criteria, including 14 quantitative, 4 qualitative and 1 mixed-methods study. Only one article reported on an Indigenous population. Few studies reported on FCR prevalence ( n = 3) or severity ( n = 9). While the variation in tools used to measure FCR hindered a robust estimate of severity, results suggested some differences in FCR severity between minority and dominant populations, although these may have been due to study metholodological differences. Few factors were reported as being associated with FCR in minorities across multiple studies. The qualitative synthesis found five themes associated with the lived experience of FCR: (i) variations in the lived experience of FCR; (ii) spirituality and worldview impacting on FCR; (iii) the importance of staying positive; (iv) complexities around support; and (v) increasing cancer knowledge. The findings of this review highlight differences in FCR across cultures and contexts, which reinforces the need for culturally-specific approaches to this condition. The dearth of research in this area is of concern given the significant burden of cancer in these populations. A deeper understanding of this condition among Indigenous and minority populations is critical to developing and delivering appropriate and effective psychosocial care for cancer survivors from these groups. Systematic Review Registration: identifier [CRD42020161655].
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Female people with cancer tend to experience heightened fear of cancer recurrence.
“and like depression and anxiety, female PWC tend to experience heightened FCR.13,14”
From Mindfulness and Psychosocial Symptoms in People with Cancer: Testing Rumination and Experiential Avoidance as Mediators, and Sex as a Moderator. (2025) · cites this paper as [14]
The Introduction discusses fear of cancer recurrence among cancer survivors generally, and the Results describe it in some groups of women, but neither establishes that female people with cancer tend to have heightened fear of recurrence. Searches for female–male comparisons and gender associations found no passage addressing that claim. Page numbers were not available in our copy. (LLM, conf=0.74)
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“…that 64.3% of PWC experience high to clinical levels of FCR, 12 and like depression and anxiety, female PWC tend to experience heightened FCR. 13,14 Fatigue is another highly prevalent symptom, present in up to 99% of PWC during treatment, and is maintained for months or years after treatment…”
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Self-citationWu, V. S., Sabud, T., Smith, A. B., Lambert, S., Descallar, J., Lebel, S., & Bamgboje‐Ayodele, A. (2023) · Current Oncology · doi:10.3390/curroncol31010005 · Cited by 1 · see citing works
“This is particularly important, as immigrant patients, who have been found to have greater unmet needs regarding FCR, [50,55] may turn to information published in their language from their home country, as they commonly do for other forms of health information [56].”
BackgroundSelf-citationResearch Status of Fear of Cancer Recurrence in Breast Cancer Patients
Ding, Y., Zhang, L., Zhang, L., & Zhong, Q. (2024) · Journal of Cancer Therapy · doi:10.4236/jct.2024.159030 · Cited by 1 · see citing works
Fear of Cancer Recurrence Among Indigenous and Tribal People
Smith, A. B., Anderson, K. M., Lebel, S., Wu, V. S., Butler, T., & Garvey, G. (2024) · Springer eBooks · doi:10.1007/978-3-031-56806-0_47 · Cited by 1 · see citing works
Self-citationLin, X., Zhang, Y., Zhang, R., Yang, S., Wang, L., Shen, Y., Sun, Y., Chen, C., Li, J., & Hao, X. (2025) · Journal of Evaluation in Clinical Practice · doi:10.1111/jep.70177 · Cited by 1 · see citing works
Managing, not lessening, uncertainty: a novel mind–body intervention for fear of cancer recurrence
Christie, A. J., Bolden, C., Park, E. R., Yeh, G. Y., O’Cleirigh, C. M., Peppercorn, J. M., Denninger, J. W., Hirschberg, A., Lee, H., Markwart, M., et al. (2025) · Journal of Cancer Survivorship · doi:10.1007/s11764-025-01886-2 · Cited by 1 · see citing works
“In the USA, guidelines on FCR treatment delivery pathways are still needed; however, guidelines from Australia and Canada have emphasized the need for scalable, group-delivered treatments for survivors with the highest levels of fear [37, 38].”
Christie, A. J., Bolden, C., Park, E. R., Yeh, G. Y., O’Cleirigh, C. M., Lee, H., Peppercorn, J. M., Wagner, L. I., Henley, E., Traeger, L. N., et al. (2025) · Global Advances in Integrative Medicine and Health · doi:10.1177/27536130251407685 · Cited by 1 · see citing works
“30,31 In addition, time since last treatment was highly variable and may account for some variance in FCR. Lastly, this trial did not include long-term assessments beyond 5 months, which may be needed to observe patterns of FCR, coping, and resilience as survivors navigate cancer-related events.”
Hundal, J., Chen, J., Russell, K. B., Carfang, L., Bedeau, A. J., Giguère, L., Ouattara, M. M., Sehabi, G., Lebel, S., Shen, S., et al. (2026) · American Society of Clinical Oncology Educational Book · doi:10.1200/edbk-26-517396 · Cited by 1 · see citing works
Self-citationSmith, B., Wu, V. S., Pearce, A., Liu, J., Shepherd, H. L., Shaw, J., Girgis, A., Garvey, G., Kirsten, L. T., Zakhary, I., et al. (2026) · Supportive Care in Cancer · doi:10.1007/s00520-026-11275-9 · Cited by 1 · see citing works
Self-citationEcosystem Barriers and Facilitators Linked to the Fear of Cancer Recurrence: An Umbrella Review
Caumeil, B., Bazine, N., Maugendre, A., & Calvin, S. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21081041 · Cited by 3 · see citing works
“The remaining two facilitators are common to the work, friendly, family spheres, namely support from family or community [21,31,37], and social support [30,38,39].”
BackgroundResearch Status of Mindfulness Decompression Therapy for Fear of Recurrence in Cancer Survivors
邓, 雨. (2022) · Advances in Clinical Medicine · doi:10.12677/acm.2022.123230 · Cited by 1 · see citing works
Wang, Q., Xia, G., Liu, F., & Yang, X. (2024) · Research Square · doi:10.21203/rs.3.rs-5322961/v1
Montgomery, J. A. (2026) · Urology · doi:10.1016/j.urology.2026.01.022
Wu, V. S., Crawford-Williams, F. M., Cook, O., Liu, J., Ftanou, M., Philp, S., Taylor, N., David, M., Zakhary, I., Tutton, L., et al. (2026) · Research Square · doi:10.21203/rs.3.rs-10491620/v1
- Authors
- Anderson, K., Smith, A. ‘., Diaz, A., Shaw, J., Butow, P., Sharpe, L., Girgis, A., Lebel, S., Dhillon, H., Burhansstipanov, L., Tighe, B., & Garvey, G.
- Affiliations
- Charles Darwin University (AU)
- UNSW Sydney (AU)
- The University of Sydney (AU)
- University of Ottawa (CA)
- Native American Cancer Research (US)
- Corresponding author
- Anderson, Kate
- ORCID
- Venue
- Frontiers in Psychology
- Publisher
- Frontiers Media SA
- Published
- 2021-05-03
- Volume
- 12
- Pages
- 621850-621850
- ISSN
- 1664-1078 (ISSN-L)
- PMC
- PMC8126623
- OpenAlex
- W3159609484
- Cited by
- 37
- References
- 50
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 11 · 2023: 6 · 2022: 5 · 2021: 1
- FWCI
- 0.70
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Psychology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- ANU Open Research (Australian National University) (submittedVersion)
- Funders
- Menzies School of Health Research
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- fear of cancer recurrence, cancer survivors, indigenous peoples, racial and ethnic minorities, lived experience, psychosocial care, cultural differences, cancer knowledge, social support
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